NPIMap

Organization Active NPI

Mark R Zust DDS LTD

Doing business as Family Dentistry of St. Peters

  • General Practice Dentistry
  • Saint Peters, MO
National Provider Identifier
1639263460
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12123 Issued in MO
Legal business name
MARK R ZUST DDS LTD
Doing business as
Family Dentistry of St. Peters
Practice address
80 Gailwood Dr
Saint Peters, MO 63376-6581
Phone
(636) 928-1100
Fax
(636) 928-1292
NPI assigned
Oct 3, 2006
Last updated
Apr 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark R Zust, DDSNPI 1245324060
Title
President
Phone
(636) 928-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12123 MO Primary

Addresses

Primary practice location

80 Gailwood Dr
Saint Peters, MO 63376-6581

Mailing address

36 4 Seasons Shopping Ctr # 300
Chesterfield, MO 63017-3103
Phone (636) 928-1100

Other names 1

  • Family Dentistry of St. Peters Doing business as

National Provider Directory

National Provider Directory

Locations

36 Four Seasons Shopping Ctr
#300
Chesterfield, MO 63017

80 Gailwood Dr
Saint Peters, MO 63376
Phone (636) 928-1100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1639263460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 4 SEASONS SHOPPING CTR # 300",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173103",
            "telephone_number": "636-928-1100",
            "fax_number": "636-928-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GAILWOOD DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766581",
            "telephone_number": "636-928-1100",
            "fax_number": "636-928-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R ZUST DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "ZUST",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-928-1100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of St. Peters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.